Zonna Xavier, Banta Conor W, Lott Ronald, Shah Shweta, Battista Anthony, Colleran Caroline
Internal Medicine, University at Buffalo, Buffalo, USA.
Internal Medicine, Geisinger Commonwealth School of Medicine, Scranton, USA.
Cureus. 2024 Aug 9;16(8):e66539. doi: 10.7759/cureus.66539. eCollection 2024 Aug.
This case report represents a 26-year-old male with no significant past medical history who presented to the emergency department in western Pennsylvania following a western diamondback rattlesnake () bite to his hand. His initial swelling was mild, and his coagulation studies were unremarkable, with minimal changes on repeat studies, and poison control recommended against antivenom administration. He was discharged home with oral antibiotics and analgesics due to his stable clinical course. However, he returned to the emergency department about 12 hours later with worsening pain and swelling that extended to his elbow. He was then given antivenom and transferred to a larger center for higher-level care, ultimately having symptom resolution after further antivenom administration. This report serves to underline the importance of clinician education regarding envenomation management throughout the United States, including areas without indigenous venomous snakes.
本病例报告介绍了一名26岁男性，既往无重大病史，在宾夕法尼亚州西部手部被西部菱斑响尾蛇（）咬伤后前往急诊科就诊。他最初肿胀较轻，凝血检查无异常，复查时变化极小，毒物控制中心建议不给予抗蛇毒血清治疗。由于其临床过程稳定，他口服抗生素和镇痛药后出院回家。然而，约12小时后他因疼痛和肿胀加剧返回急诊科，肿胀已蔓延至肘部。随后他接受了抗蛇毒血清治疗，并被转至更大的中心接受更高级别的护理，在进一步给予抗蛇毒血清后最终症状得到缓解。本报告旨在强调在美国各地，包括没有本土毒蛇的地区，临床医生接受关于蛇咬伤处理教育的重要性。
